Guide to Completing an Employer

Incident Investigation Report (EIIR)

Save time and money by using the EIIR template to easily create all your required incident investigation reports.
WorkSafeBC has developed an employer incident
investigation report (EIIR) template you can use to
create all four reports that may be required
following an incident in your workplace. This
template will help you collect all the necessary
information and reduce the work associated with
completing multiple, separate reports.

What is this guide for?

This guide will walk you through the process of
completing an EIIR, in conjunction with the
requirements of Part 3, Division 10, of the
Workers Compensation Act (the Act) and
prevention policies D10-175-1 and D10-176-1.

How many reports do I need to

complete?
Depending on the incident, you may be required
to complete up to four separate reports. Each
report represents the status of the investigation at
a specific point in the investigation process.

Report
type

When

Template
sections

Preliminary
investigation

Complete
within 48 hours

1 to 14

Interim
corrective action

As soon as
possible

1, 9, and 12

Full investigation

Complete
within 30 days

1 to 19

Full corrective
action

As soon as
possible

1, 9, and 17

How do I submit a report to

WorkSafeBC?
Generally, you are only required to submit full
investigation reports to WorkSafeBC. You can
submit full investigation reports:
Online at the EIIR upload portal
By fax at 604.276.3247 in the Lower Mainland
or toll-free 1.866.240.1434
By mail to WorkSafeBC, PO Box 5350, Stn
Terminal Vancouver, BC V6B 5L5

When is an investigation required?

Employers are required to immediately investigate
any incident that involves the following:
(1) Serious injury to or death of a worker
(2) A major structural failure or collapse
(3) A major release of a hazardous substance
(4) Fire or explosion with potential for serious injury
(5) A blasting accident causing personal injury
(6) Dangerous incident involving explosives,
whether or not there is personal injury
(7) A diving incident, as defined by the
Occupational Health and Safety Regulation
(8) Minor injury or no injury but had potential for
causing serious injury
(9) Injury requiring medical treatment beyond
first aid
Note: For the first six types of incidents, you
must also notify WorkSafeBC immediately. Call
toll-free 1.888.621.7233. After hours call
1.866.922.4357.
If the incident is not one of the types listed above
(for example, it was a minor incident and there
was no risk of serious injury), you are not
required to investigate it.

Guide to Completing an Employer Incident Investigation Report (EIIR)

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What to do following a workplace incident

Workplace
incident
occurs

Immediately

Within 48 hours

Within 3 days

Within 30 days

Ongoing

Notify
WorkSafeBC
if the incident
is one of the
rst six types
listed under
When is an
investigation
required?

Conduct
preliminary
investigation
and prepare
report

If a worker
was injured,
submit Form 7
Employers
Report of
Injury or
Occupational
Disease

Complete full
investigation
and prepare
report

Follow up to
ensure
corrective
action is in
place and
eective

WorkSafeBC
may request

Full report to
WorkSafeBC

After producing
report

After producing
report

Undertake
corrective
action as
required and
prepare report

Undertake
corrective
action as
required and
prepare report

Provide reports
to workers*

Provide reports
to workers*

If full investigation and corrective action can be completed

within 48 hours, you may combine the reports

* Provide to the joint health and safety committee or worker health and safety representative, as applicable.
If there is no joint committee or worker representative, post the report in the workplace.

Step 1: Preliminary investigation report

When an incident occurs, you must conduct a
preliminary investigation to identify any unsafe
conditions, acts, or proceduresas much as
possibleto identify and manage hazards in the
workplace. This helps ensure that work can be done
safely during the interim period between the incident
and the conclusion of the full investigation.
When the preliminary investigation is complete,
open the EIIR template and enter the incident
details in sections 1 to 14. Save the file as a
Microsoft Word or PDF file, indicating the date
of the incident, the injured workers name, and
the type of report (preliminary investigation).
Complete this report within 48 hours.
Preliminary investigation reports must be initiated
immediately and must contain all information
specified by policy. Dont submit your preliminary

investigation report to WorkSafeBC unless you

have been directed to do so by an officer.

Section 1: Employer information

Provide the employers legal name, operating
name or trade name, address, contact number,
email address, WorkSafeBC account number,
and operating location number.

Section 2: Injured persons

Provide the names and job titles of individuals
injured or killed in the incident, even if they dont
work for the employer.

Section 3: Place, date, and time of incident

For incidents in remote locations or away from the
employers mailing address, include whatever
identifying information is available. This may
include GPS coordinates, mile markers, or street
intersections.

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Section 4: Type of occurrence

Use this section to indicate the type of incident you
are investigating. You are legally obligated to
investigate and report certain types of incidents.
If its a first aid-only injury and there was no risk of
serious injury, you are not required to investigate it.
You are not required to investigate a vehicle
accident occurring on a public street or highway.

dates and times, if possible. Arrange the events in

chronological order, from first to last. Dont include
things that should have happened but did not
(for example, worker did not use guard). For more
information on developing a sequence of events,
see these training materials, which are listed at the
bottom of the web page under Investigation of
Accidents and Incidents.

Section 10 of the template lists examples of

serious injuries. A major release is defined in
Policy D-10-172-1.

Section 9: Unsafe conditions, acts, or

procedures that significantly contributed to
the incident

Section 5: Report type

Indicate whether this is a preliminary investigation,
interim corrective action, full investigation, or full
corrective action report. If you are using the EIIR
template for multiple reporting obligations, select
all the report types that apply. For example, if you
have completed the preliminary investigation and
identified and taken corrective action, select the
Preliminary investigation report box and the
Interim corrective action report box.
Indicate if this is a revision to a previously
documented report. If this is a preliminary
investigation report requested by an officer, note
the officers name.

Section 6: Witnesses
Provide the names and job titles of any witnesses
to the incident, including workers or members of
the public.

Analyze the sequence of events. Ask why each

event happened. Describe any unsafe conditions,
acts, or procedures (for example, poor
housekeeping or failure to follow safety
procedures). Avoid stopping at personal factors,
such as worker was careless. Consider possible
problems with factors such as training,
equipment maintenance, standard work
procedures, and environmental conditions.

Section 10: Nature of serious injury

You may use this section to indicate the nature of
the injury, if applicable. According to Guideline
G-D10-172-1, a serious injury is any injury that
can reasonably be expected at the time of the
incident to endanger life or cause permanent
injury. Serious injuries include traumatic injuries
such as fractures of the arms or legs, major cuts,
burns and crush injuries.

Section 11: Brief description of the incident

Section 7: Other persons whose presence

might be necessary for a proper investigation

Summarize what happened based on the

information in sections 8, 9, and 10.

Provide the names and job titles of anyone who

is needed to conduct the investigation. This may
include workers who were on shift before the
incident, someone who maintained equipment
involved in the incident, or third-party
consultants.

Section 12: Corrective actions identified and

taken to prevent recurrence of similar incidents

Section 8: Sequence of events that preceded

the incident
Identify significant events that led up to the
incident. You can also include relevant events that
followed the incident, such as first aid. Include

Describe the corrective actions you have

identified to prevent similar incidents. Include the
action, the name and job title of the person
responsible for it, and the completion date or
anticipated completion date.

Section 13: Explanation of blank areas on

this preliminary report, if any
You are expected to take reasonable steps to
investigate the incident and identify unsafe

Guide to Completing an Employer Incident Investigation Report (EIIR)

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conditions, acts, or procedures as much as

possible. Circumstances outside an employers
control may restrict the investigation for
example, not being able to access the incident
scene because of an ongoing police investigation.
If you cant complete the preliminary
investigation you should still provide any
information you have available.

Section 14: Persons who carried out or

participated in the preliminary investigation
Include the name and job title of anyone who
took part in the employers incident investigation.

Step 2: Interim corrective action report

Interim corrective action reports must address
the findings of the preliminary investigation. If all
interim corrective action was completed when
the preliminary report was written, you have
already completed the corrective action report
and can check both boxes in section 5
(preliminary investigation report and interim
corrective action report).
If some actions still need to be done, open the
preliminary investigation report and rename the
file to indicate that this is the interim corrective
action report. Update the information in sections
9 and 12 with any new actions or dates. If some
actions still have not been done at the end of the
full investigation, ensure they are included in your
full corrective action report.
The information you provide in sections 1 to
14 is sufficient to satisfy your legal obligation
to prepare both a preliminary incident
investigation report and interim corrective
action report. You must provide these
reports to your joint occupational health
and safety committee (or worker health
and safety representative, if applicable).
If there is no joint committee or worker
representative, the reports must be posted in
the workplace. Dont send these reports to
WorkSafeBC unless an officer asks for them.

Step 3: Full investigation report

In the full investigation, you must determine the
causes of the incident. These causes could
include underlying problems with supervision,
training, preventative maintenance, or other
management systems.
When you have completed the full investigation,
open the interim corrective action report and
rename it (full investigation report). Check the box
in section 5. Add information to sections 15 to
19. Submit the report to WorkSafeBC within 30
days of the incident. Dont submit attachments to
the report, such as photos, videos, and drawings.
Instead, keep them at the workplace.

Section 15: Determination of causes of

incident
Analyze the facts and circumstances of the
incident to identify the underlying factors that led
to it. What underlying factors made the unsafe
conditions, acts, or procedures possible? Identify
health and safety deficiencies.

Section 16: Full description of the incident

Use the brief description from the preliminary
report as a starting point. Expand on it, as
necessary.

Section 17: Additional corrective actions

necessary to prevent recurrence of similar
incidents
Provide information about the corrective actions
you have identified to prevent similar incidents.
Include the action, the name and job title of the
person responsible for it, and the completion
date or anticipated completion date.
Note: If all the corrective actions have been
completed by the time you write the full report,
this report can also serve as the full corrective
action report. In this case, remember to check
both boxes in section 5.

Section 18: Persons who carried out or

participated in the full investigation
Include the names and job titles of those who
took part in the employers incident investigation.

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Section 19: Other relevant workplace parties

Depending on the nature of your workplace, there
may be other people, such as prime contractors or
property owners, who have duties or
responsibilities for workplace safety. Identify any
other person actively involved in the incident, and
include the name and contact information for these
other workplace parties, if applicable.
The information you provide in sections
1 to 19 is sufficient to satisfy your legal
obligation to prepare a full incident
investigation report. You must provide this
report to your joint occupational health
and safety committee (or worker health
and safety representative, if applicable).
If there is no joint committee or worker
representative, the reports must be posted in
the workplace.

Step 4: Full corrective action report

If there are still outstanding, incomplete corrective
actions when you write the full investigation
report, then you may be unable to complete the
full corrective action report at that time. When all
the corrective actions have been completed, open
the full investigation report and rename it (full
corrective action report). Add the completion
dates in section 17 (and section 9, if any).
You must provide this report to your joint
occupational health and safety committee (or worker
safety representative, if applicable). If there is no
joint committee or worker representative, you must
post the report in your workplace. Dont send this
report to WorkSafeBC unless an officer asks for it.

What formats is the EIIR template

available in?
The template is available in two formats: PDF and
Word. The PDF template is dynamic you can
type in the fields. However, it cant be customized
with additional fields.

The Word template also has dynamic fields you can

type in. You may wish to customize the template by
adding a company logo, more fields for tracking and
categorizing incidents, or more rows in different
sections (for complex or large investigations).

Do I have to use the EIIR template?

Employers are not required to use the template.
You can choose to continue using your own
methods of recording incident investigations on
your own forms.
Regardless of the reporting format used, your
reports must contain the information required by
Policy D10-175-1 and Policy D10-176-1 in order
to comply with sections 175(2)(a) and 176(2)(a) of
the Act.
If you are using your own form, please attach a
cover sheet that includes any required information
that isnt covered in your form. The cover sheet
should include:
Your WorkSafeBC account number and
operating location
The type of report you are submitting (full
investigation or other)
The type of incident (for example, a minor
injury, a near miss, or a serious injury)

What are the timelines?

You must initiate the preliminary investigation
immediately and complete a preliminary
investigation report within 48 hours of the
incident. You must also initiate the full investigation
and submit the full investigation report to
WorkSafeBC within 30 days of the incident,
unless WorkSafeBC grants an extension.
Depending on the complexity of the incident, you
might be able to complete your full investigation
report within 48 hours. (See Can I combine
reports?)
The 48-hour period can be extended if it expires
on a Sunday or other holiday, or it expires on a
day you are not normally open.

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You must provide the corrective action report to

your joint occupational health and safety committee
(or worker safety representative, if applicable) as
soon as possible after the corrective action occurs.

How should I organize my

investigation files?
We recommend that when an incident occurs
you open the template and save it as a Word or
PDF file with a name that indicates the date of the
incident, the injured workers name, and the type
of report. For example, you could save a file as:
2015-12-27 John Doe Preliminary
If there was no injury, a near-miss incident could
be saved as:
2015-12-27 Near Miss Preliminary
When you move to step 2 (the corrective action
report), open the preliminary report, rename it, and
update the information. For example, rename the file
2015-12-27 John Doe Interim

When can I combine reports?

Depending on the complexity of the incident
investigation, it may be possible to complete the full
investigation report and resulting corrective action
within 48 hours. In this situation, you may combine
one or more reports as long as you meet all the
requirements and complete the reports within the
required time. Policy D10-176-1 describes what to
do when the incident investigation and resulting
corrective action are completed within 48 hours.

Who needs to conduct the investigation?

Your incident investigation must be carried out by
people who are knowledgeable about the type of
work involved. The employer, or a representative
of the employer, and a worker representative
must participate if they are reasonably available.
That means each investigation will be carried out
by at least two people, maybe more for complex
investigations.

When you have completed the full investigation,

open the interim file, rename it, and complete the
information in sections 15 to 19. For example,
rename the file:
2015-12-28 John Doe Full

Participation in the investigation will include:

Viewing the scene of the incident with those
carrying out the investigation
Providing advice to the people carrying out the
investigation
Any other activities prescribed by WorkSafeBC

When you have completed all the corrective

actions, it is time to complete the full corrective
action report. Open the full report, rename it, and
finalize the information in section 17. For example,
rename the file:
2015-12-28 John Doe Corrective

People participating in the investigation must have

adequate training to be able to fulfill their
responsibilities. They should understand the
investigation process and be able to analyze the
sequence of events to find all factors contributing
to the incident.

Naming and organizing your files in this way,

helps keep all reports together and minimizes
re-entering data in the reports.

Can I hand write the full investigation

report?
Both the Word and PDF versions of the template
are formatted to be printed and may allow enough
space for you to write in the needed information.
You could then scan the print document as either
a PDF or JPG file and submit it online.

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